Information Collection

Athlete weekly surveillance report

IC 215896 under ICR 201511-0920-011 · OMB 0920-1073.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Athlete weekly surveillance report	Form
Athlete weekly surveillance report AttachF-Weekly Ath IVR_rev0323.doc	Form
AttachR_Weekly Report Follow Up email phone script.docx Weekly report follow-up	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Athlete weekly surveillance report	AttachF-Weekly Ath IVR_rev0323.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title: Records of subjects in health promotion and educational studies

FR Citation: 51 FR 42484

Number of Respondents: 1,518

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	15,180	15,180
Annual IC Time Burden (Hours)	759	759
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Weekly report follow-up	AttachR_Weekly Report Follow Up email phone script.docx	03/30/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.